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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SUBLETTE COUNTY HOSPITAL DISTRICT
NPI 1104410596
Family Medicine in Pinedale, WY

Active since February 25, 2021CLIA Certified · 2 labs
625 E HENNICK ST, PINEDALE, WY 82941(307) 367-4133(307) 459-8576 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 14, 2026, Mar 18, 2025, Jun 7, 2023 and 2 more (5 updates tracked since 2021).

About Sublette County Hospital District NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUBLETTE COUNTY HOSPITAL DISTRICT (NPI 1104410596), doing business as Pinedale Medical Clinic, is a healthcare organization registered as a family medicine in Pinedale, Wyoming and active in the NPI registry since February 2021. The organization holds 2 active CLIA laboratory certificates and lists Rex Walk, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1104410596
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSUBLETTE COUNTY HOSPITAL DISTRICT
Location Address625 E HENNICK STPinedale, WY 82941-5228
Mailing AddressPo Box 627Pinedale, WY 82941-0627 · (307) 367-4133 · Fax (307) 459-8576
Phone(307) 367-4133
Fax(307) 459-8576
Organization SubpartNo
Authorized OfficialRex WalkChief Executive Officer · (307) 367-0150
Enumeration DateFebruary 25, 2021
Last NPPES UpdateJuly 14, 20265 updates tracked since enumeration
NPPES CertifiedJuly 14, 2026
✔ NPI 1104410596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
625 E HENNICK ST, Pinedale, WY 82941
Open in Google Maps ↗

Other Names 1

Doing Business AsPinedale Medical Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 53D2327327

Sublette County Hospital District Dba Pinedale Medical Clinic · Pinedale, WY
Active · expires Jul 20, 2027
CLIA Number53D2327327
Laboratory TypeCommunity Clinic
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorSharon D. Rutsch
Laboratory Phone(307) 367-4133
Laboratory LocationSublette County Hospital District Dba Pinedale Medical Clinic625 E Hennick St, Pinedale, WY 82941
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 53D0520195

Sublette County Hospital District Dba Sublette County Health · Pinedale, WY
Active · expires Mar 19, 2027
CLIA Number53D0520195
Laboratory TypeHospital
Certificate Effective DateMarch 20, 2025
Certificate Expiration DateMarch 19, 2027
Laboratory DirectorDr. Edward J. Callaghan
Laboratory Phone(307) 367-4133
Laboratory LocationSublette County Hospital District Dba Sublette County Health615 E Hennick St, Pinedale, WY 82941
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RAULI JO PERRY WHNP-BC
Nurse Practitioner (Women's Health)
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (307) 367-4133
APOGEE MEDICAL GROUP WYOMING PC
Internal Medicine
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (214) 592-1329
KERI LYNN HULL ARNP
Nurse Practitioner (Family)
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (307) 367-4132
SUBLETTE COUNTY HOSPITAL DISTRICT
Clinic/Center (Urgent Care)
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (307) 367-4133
DARYL MCLAREN MD
Emergency Medicine
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (307) 367-4133
UNIVERSITY OF UTAH ADULT SERVICES
Internal Medicine (Cardiovascular Disease)
625 E HENNICK ST
PINEDALE, WY 82941
Sublette County (801) 581-2121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sublette County Hospital District's NPI number?

The NPI number for Sublette County Hospital District is 1104410596. It was assigned to this organization in the NPPES registry on February 25, 2021. The provider is doing business as Pinedale Medical Clinic.

Where is Sublette County Hospital District located?

Sublette County Hospital District is located at 625 E Hennick St, Pinedale, WY 82941. The listed phone number is (307) 367-4133.

What is Sublette County Hospital District's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Sublette County Hospital District hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Sublette County Hospital District accept?

Health plans from Blue Cross Blue Shield of Wyoming list Sublette County Hospital District as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sublette County Hospital District was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.